The Controlling Nutritional Status Score Is a Significant Independent Predictor of Poor Prognosis in Patients With Malignant Pleural Mesothelioma

Clin Lung Cancer. 2017 Jul;18(4):e303-e313. doi: 10.1016/j.cllc.2017.01.008. Epub 2017 Feb 2.


Introduction: Malignant pleural mesothelioma (MPM) is a devastating neoplasm; however, some patients exhibit a good response to chemotherapy or multidisciplinary therapy, including surgery and chemotherapy. It is therefore important to discover the factors that can be used to select patients who will benefit from such treatment. Although the Controlling Nutritional Status (CONUT) score has been used to predict the prognosis in other types of malignancy, its utility in patients with MPM is unknown. The aim of this study was to clarify the clinical significance of the CONUT in patients with MPM.

Methods: The data of 83 patients, who were treated with surgery, chemotherapy, or multidisciplinary therapy, were analyzed in the present study. A cut-off CONUT score of 2 was used to classify all of the patients into low or high CONUT groups.

Results: Fifty-two of the 83 patients were classified into the low CONUT group. A high CONUT score was significantly correlated with chemotherapy alone (P = .011). The high CONUT group had significantly poorer overall survival (OS) (P < .001) and disease- or progression-free survival (DFS/PFS) (P < .001). The clinical stage and the CONUT score were found to be independent predictive factors for the OS: clinical stage, I/II and III/IV; P = .001 and CONUT score, ≥ 3 and ≤ 2; P = .011, respectively. The clinical stage and the CONUT score were also independent predictive factors for DFS/PFS: clinical stage, I/II and III/IV; P = .006 and CONUT score, ≥ 3 and ≤ 2; P = .013, respectively.

Conclusions: The CONUT score was an independent predictor of a poor prognosis in the patients with MPM. This score provides useful information for selecting patients who will benefit from the treatment.

Keywords: Controlling nutritional status; Immune-nutritional index; Malignant pleural mesothelioma; Malnutrition; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Pharmacological*
  • Female
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / therapy
  • Male
  • Mesothelioma / diagnosis*
  • Mesothelioma / mortality
  • Mesothelioma / therapy
  • Mesothelioma, Malignant
  • Middle Aged
  • Neoplasm Staging
  • Nutrition Assessment
  • Nutritional Status*
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / mortality
  • Pleural Neoplasms / therapy
  • Prognosis
  • Survival Analysis


  • Biomarkers, Pharmacological